Regional disparity in continuously measured time-domain cerebrovascular reactivity indices: a scoping review of human literature

Abstract

Cerebral blood vessels maintaining relatively constant cerebral blood flow (CBF) over wide range of systemic arterial blood pressure (ABP) is referred to as cerebral autoregulation (CA). Impairments in CA expose the brain to pressure-passive flow states leading to hypoperfusion and hyperperfusion. Cerebrovascular reactivity (CVR) metrics refer to surrogate metrics of pressure-based CA that evaluate the relationship between slow vasogenic fluctuations in cerebral perfusion pressure/ABP and surrogate for pulsatile CBF/cerebral blood volume. We performed a systematically conducted scoping review of all available human literature examining the association between continuous CVR between more than one brain region/channel using the same CVR index. In all the included 22 articles, only handful of transcranial doppler (TCD) and near-infrared spectroscopy (NIRS) based metrics were calculated for only two brain regions/channels. These metrics found no difference between left and right sides in healthy volunteer, cardiac surgery, and intracranial hemorrhage patient studies. In contrast, significant differences were reported in endarterectomy, and subarachnoid hemorrhage studies, while varying results were found regarding regional disparity in stroke, traumatic brain injury, and multiple population studies. Further research is required to evaluate regional disparity using NIRS-based indices and to understand if NIRS-based indices provide better regional disparity information than TCD-based indices.

Time-Series Modeling and Forecasting of Cerebral Pressure–Flow Physiology: A Scoping Systematic Review of the Human and Animal Literature

“…Our reporting adhered to the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) [ 15 ] and PRISMA Extension for Scoping Review [ 16 ]. The methodology and search approach employed in this review closely align with previous systematic reviews carried out by our research team [ 17 , 18 ]. The formulation of review objectives and the design of the search strategy were a collaborative effort involving the primary (NV, LF) and senior (FZ) authors.…”

Continuous monitoring methods of cerebral compliance and compensatory reserve: a scoping review of human literature

“…We followed the guidelines outlined in the preferred reporting items for systematic reviews and meta-analysis (PRISMA) (Page et al 2020) and the PRISMA Extension for Scoping Review in our reporting (Tricco et al 2018). The methodology and search resembled those utilized in previous systematic reviews conducted by the research team (Gomez et al 2022, Sainbhi et al 2023. The collaborative efforts of the primary authors (AI and LF) and senior author (FAZ) formulated the review objectives and developed the search strategy.…”